Summary & Overview
HCPCS G9604: Patient Survey Results Not Available
HCPCS Level II code G9604 indicates that patient survey results are not available for a given encounter or reporting period. Nationally, accurate documentation of patient experience metrics affects quality reporting, value-based payment programs, and administrative records; a specific code for unavailable survey data helps standardize reporting and distinguishes missing survey data from negative or neutral responses. Key payers in this national overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what G9604 represents, the typical service context where it is applied (administrative documentation related to patient experience in outpatient and ambulatory settings), and how payers commonly include this designation in claims and quality reporting workflows. The publication provides benchmarks and context for coding practices, summaries of payer coverage considerations, and relevant policy and reporting implications. Where input data is incomplete, the text notes that specific associated taxonomies, ICD-10 pairings, and related codes are not available in the input. The focus is national in scope and intended to clarify the code's purpose for billing, reporting, and administrative stakeholders.
Billing Code Overview
HCPCS Level II code G9604 denotes patient survey results not available. This code is used to indicate that standardized patient experience or satisfaction survey results are not available for the patient encounter or reporting period. The service type is administrative/documentation of patient-reported experience data, and the typical site of service is outpatient or ambulatory settings where patient surveys are routinely collected, such as clinics, physician offices, and outpatient facilities.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A patient scheduled for a mailed or electronic patient-experience or functional outcome survey presents for follow-up after an outpatient visit. The health center’s quality team determines that the patient’s survey results are not available for inclusion in the encounter record because the patient did not receive, complete, or return the instrument, or because the vendor failed to deliver results in time for documentation. The clinician documents that a standardized patient survey was attempted but results are unavailable and proceeds with care planning and shared decision-making based on clinical assessment and patient report. Typical workflow steps include: ordering or triggering the survey in the electronic health record, attempting distribution (mail, portal, or phone), waiting for vendor data import, checking survey status before the visit, and documenting absence of results in the chart. Billing staff use G9604 to indicate the survey results were not available for that encounter when reporting quality measure data or encounter-level survey status to payors or quality programs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when documentation supports substantially greater effort related to the visit due to managing absence of survey data (rare for this code). |